Patients with early breast cancer (n = 1022) were treated between March 1970 and October 1975 in a prospective clinical trial. The results are presented after follow-up of 5-10 years. Clinical stage I cancer cases (n = 714) were randomly allocated to treatment by simple mastectomy and postoperative radiotherapy, or simple mastectomy alone. There was no statistically significant difference in overall survival between the two groups. There was a significant reduction in the frequency of local recurrence in those who received early postoperative radiotherapy compared with those who did not. Clinical stage II cancer cases (n = 308) were randomly allocated to treatment by simple mastectomy and postoperative radiotherapy or radical mastectomy alone. There was no statistically significant difference in survival or in the frequency of local recurrence between the two groups.
In a prospective randomized controlled clinical trial, anterior lesser curve seromyotomy with posterior truncal vagotomy (AMPT, n = 77) has been compared with truncal vagotomy and pyloroplasty (TVP, n = 69) in 146 patients with chronic duodenal ulcer with a mean duration of symptoms of 7 years. The mean follow-up time was 4.5 years with a range of 2-7 years. One elderly patient died from a myocardial infarction in the TVP group. Acid secretory inhibition in response to insulin and pentagastrin stimuli was equal in both groups, indicating a similar degree of vagal denervation. Recurrent ulcers were more common after AMPT (five) than TVP (two) (P = 0.29, n.s.). Dumping and diarrhoea were significantly commoner (P less than 0.001) after TVP, with 31 instances as opposed to eight with AMPT. The mean operating time was increased by 6 min when AMPT was performed rather than TVP. The results of this study have shown that AMPT is associated with a lower incidence of dumping and diarrhoea and achieves better overall Visick grading. However, continued monitoring is required to assess the long-term incidence of recurrent ulceration after this procedure.
Data relating to 1022 patients with early breast cancer who were entered into a clinical trial have been analysed to assess the importance of various factors in predicting prognosis. Clinical stage was the major determinant of prognosis, and in each stage patients with a breast tumour 2 cm or less in maximum diameter had a significantly better survival than patients with larger tumours. Patients aged between 40 and 49 years and premenopausal patients had relatively favourable prognosis. Site of the tumour within the breast, whether it was situated on the left or the right side, the patient's martial status and the number of pregnancies did not appear to have any influence.
A survey has been performed of the mortality and morbidity of anterior lesser curve seromyotomy with posterior truncal vagotomy in the elective treatment of chronic duodenal ulcer. There was one death in a series of 605 patients due to a myocardial infarction, an operative mortality of 0.16 per cent. There was no case of ischaemic necrosis of the lesser curvature or fundus of the stomach. Eleven patients had symptoms of delayed gastric emptying (1.7 per cent) and seven of these underwent a drainage procedure (1.3 per cent). Postoperative dumping did not occur, significant diarrhoea was present in two patients (0.33 per cent). This operation is relatively simple, quick and extremely safe to perform. It is suggested that the more widespread use of this type of elective surgery for duodenal ulcer might reduce the mortality from the condition.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations –citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.